真实世界中医药治疗600例肺炎患者的疗效分析

Analysis of the curative effect of 600 cases of pneumonia treated with traditional Chinese medicine in the real world

目的:基于真实世界数据评价中医药治疗肺炎的疗效及安全性。方法:北京市丰台区中医医院2022年10月—2023年10月收治的600例肺炎患者,采用随机数字表法分为西药组和中药组,每组300例。西药组口服左氧氟沙星片,0.25 g/次,2次/d;当体温超过38.5℃时口服布洛芬,每次0.4 g。中药组口服“三合一方”中药汤剂,1剂/d,水煎早晚分服。两组均5 d为1个疗程,共治疗2个疗程。比较两组患者平均住院时间、平均退热时间、肺部炎症消退时间、咳嗽缓解时间、临床症状改善时间。结果:两组患者均未发生严重不良事件。与西药组比较,中药组平均住院时间、平均退热时间、肺部炎症消退时间、咳嗽缓解时间、临床症状改善时间更短,差异均有统计学意义(P<0.05,P<0.01)。中药组治疗前19例患者为淡红舌,281例为红舌。治疗后,共有276例患者为淡红舌,其中苔薄白236例,苔白腻24例,苔白厚16例;有24例患者为红舌,其中苔薄黄15例,苔黄厚9例。说明中药治疗后,患者热象、湿象均明显消退。而西药组治疗前有17例患者为淡红舌,283例为红舌。治疗后共有252例患者为淡红舌,其中苔薄白79例,苔白腻156例,苔白厚17例;有48例患者为红舌,其中苔薄黄17例,苔黄厚31例。说明经西药治疗后,患者的热象明显消退,但湿象仍比较明显,甚至有的患者湿象加重。两组患者舌像比较,差异具有统计学意义(P=0.007)。结论:中医药治疗肺炎有一定的疗效和优势,能够有效缩短病程,改善发热、咳嗽等症状,并缩短症状消失时间。

Objective:To evaluate the efficacy and safety of TCM in treating pneumonia based on real-world data.Methods:600 patients with pneumonia admitted to Fengtai District Hospital of Traditional Chinese Medicine from October 2022 to October 2023 were divided into western medicine group and Chinese medicine group by random number table method.Patients in the western medicine group were treated with levofloxacin tablets,0.25g/each time,twice a day;Ibuprofen was given orally,0.4g/each time,when the patient′s body temperature exceeded 38.5℃.The patients in the Chinese medicine group took Sanheyi Formula orally which was decocted in water,1 dose/d for the morning and evening.In both groups,5 days was a course of treatment,and a total of 2 courses of treatment were required.The average length of hospital stay,average antipyretic time,lung inflammation regression time,cough relief time and clinical symptoms improvement time were compared between the two groups.Results:No serious adverse events occurred in both groups.Compared with those in the western medicine group,the average length of hospital stay,average antipyretic time,lung inflammation regression time,cough relief time,clinical symptoms improvement time in the Chinese medicine group were shorter,and the differences were statistically significant(P<0.05,P<0.01).In the Chinese medicine group,19 patients had light red tongue and 281 patients had red tongue before treatment.After treatment,a total of 276 patients had light red tongue,including 236 cases with thin white tongue coating,24 cases with white and greasy tongue coating,and 16 cases with thick white tongue coating;24 patients had red tongue,including 15 patients with thin yellow tongue coating and 9 patients with thick yellow tongue coating.The results showed that after treatment with Chinese medicines,the thermal and wet manifestations of the patients subsided significantly.In the western medicine group,there were 17 patients with light red tongue and 283 patients with red tongue before treatment.After treatment,a total of 252 patients had light red tongue,including 79 cases with thin white tongue coating,156 cases with white and greasy tongue coating,and 17 cases with thick white tongue coating;48 patients had red tongue,including 17 patients with thin yellow tongue coating and 31 patients with thick yellow tongue coating.The results showed that after the treatment of western medicines,the thermal manifestations of the patients disappeared obviously,but the wet manifestations were still obvious,and some patients even got worse wet manifestations.The difference of tongue image between the two groups was statistically significant(P=0.007).Conclusion:Traditional Chinese medicine has certain curative effect and advantages in the treatment of pneumonia,which can effectively shorten the course of disease,improve the symptoms such as fever and cough,and shorten the disappearance time of symptoms.